The impact of an All-Hazard mass casualty event on emergency department operations: A retrospective study.

Background: Mass Casualty Events (MCI) which have a direct and persisting impact on the safety and well-being of an emergency department (ED) and its staff, secondary to specific targeting of the healthcare setting, represent a distinct and complex operational challenge. ED physicians may be faced with the prospect of providing ongoing patient care while simultaneously experiencing direct threats to their own health or physical safety. In our study we considered the unique operational challenges encountered, and management strategies adopted, by the ED staff and its leadership to an all-hazard MCI impacting an academic urban emergency department.

Predictive Factors and Risk Assessment for Hospitalization in Chest Pain Patients Admitted to the Emergency Department.

Background: Chest pain is one of the most common reasons for emergency department (ED) visits. Patients presenting with inconclusive symptoms complicate the diagnostic process and add to the burden upon the ED. This study aimed to determine factors possibly influencing ED decisions on hospitalization versus discharge for patients with the diagnosis of chest pain.

COVID-19 Quarantine and Sexual Function after First Vaginal Delivery.

Objectives: Sexual function is an important part of quality of life at all ages. Childbirth brings many changes that may affect sexual function. During COVID-19 global pandemic, nuclear families were forced to stay home.

Antioxidant status in pediatric acute lymphocytic leukemia (ALL) and solid tumors: the impact of oxidative stress.

Background: Pediatric ALL patients are subjected to an aggressive and continuous chemotherapy protocol, while solid tumor patients have a less intensive treatment. We studied the antioxidant status of children from the two groups and hypothesized that the antioxidant status will differ in concert with their treatment.

Procedure: The antioxidant status in plasma of seven ALL children and that of six children treated for different solid tumors, in regard to the different treatment regimen, was compared with healthy controls.

Antioxidant properties of bucillamine: possible mode of action.

The antioxidant properties of Bucillamine (BUC), a di-thiol compound used for treatment of rheumatoid arthritis (RA) and its possible mode of action, were investigated. BUC exhibits potent antioxidant activity similar to those of trolox and ascorbic acid. It reduces the stable free radical diphenyl-2-picrylhydrazyl (DPPH) with IC(50) of 18.

The role of erythrocyte aggregation in the abnormal hemorheology of multiple myeloma patients.

Objectives: The aim of this study is to clarify whether increased aggregation of red blood cells (RBCs) of multiple myeloma (MM) patients is caused by changes in plasma chemical composition or is associated with alterations in RBC properties and in addition, to suggest an approach to revert the enhanced aggregation in MM toward normal.

Materials And Methods: 40 blood samples of MM patients and suspensions of control RBCs in MM plasma were examined. In addition, RBC aggregation in MM blood was studied in the presence of dextrans with mean molecular weights of 9.

Acoustic cavitation in phacoemulsification and the role of antioxidants.

Cataract surgery by phacoemulsification generates acoustic cavitation, resulting in formation of reactive oxygen species. The aim of this study was to establish the mechanism of damage by phacoemulsification in an in vitro setting simulating cataract surgery and to assess the protective effects of water-soluble antioxidants. Electron paramagnetic resonance spectroscopy was used to analyze generation of radicals in an intraocular irrigating solution by phacoemulsification instrumentation, operating at an ultrasonic frequency range of 40--60 kHz.

Induction of protein oxidation by intravenous iron in hemodialysis patients: role of inflammation.

Background: Oxidative stress and inflammation contribute to the high prevalence and severity of atherosclerosis, infections, and beta2-microglobulin amyloidosis; and thus, to reduced survival rate and quality of life in hemodialysis (HD) patients. Inflammation induces oxidative stress by production of the oxidants: superoxide anion, hydrogen peroxide, and hypochlorite. Intravenous iron (IVIR), administered in HD patients to correct anemia, can release free iron, that may react with hydrogen peroxide to produce the strong oxidant hydroxyl radical.

Possible oxidative stress involvement in congenital dyserythropoietic anemia type 1.

Introduction: Congenital dyserythropoietic anemia type 1 (CDA1) patients may suffer from iron overload, associated with oxidative damage. The aim of this study was to evaluate possible involvement of oxidative stress in the pathogenesis of CDA1.

Study Design: : Blood samples from 10 children diagnosed as CDA1 patients from five Bedouin families, were studied.

Quantitative determinations of microcytic-hypochromic red blood cell population and glycerol permeability in iron-deficiency anemia and beta thalassemia minor.

The Hl/H2 Technicon automated cell analyzer measures, in addition to the usual red blood cell (RBC) parameters, subpopulations of microcytic (M) and hypochromic (H) red blood cells. The M/H ratio may be useful in the differential diagnosis of iron-deficiency anemia (IDA) and beta thalassemia minor (Thal). Thirty-three iron-deficient patients and 26 thalassemia patients were studied.

Effect of vitamin K1 on glucose-6-phosphate dehydrogenase deficient neonatal erythrocytes in vitro.

Aim: To determine whether vitamin K1, which is routinely administered to neonates, could act as an exogenous oxidising agent and be partly responsible for haemolysis in glucose-6-phosphat-dehydrogenase (G-6-PD).

Methods: G-6-PD deficient (n = 7) and control (n = 10) umbilical cord blood red blood cells were incubated in vitro with a vitamin K1 preparation (Konakion). Two concentrations of Vitamin K1 were used, both higher than that of expected serum concentrations, following routine injection of 1 mg vitamin K1.

Red blood cell permeability to thiol compounds following oxidative stress.

The permeability of red blood cells (RBCs) to thiol containing compounds, reduced glutathione (GSH) and N-acetyl cysteine (NAC), has been studied in control adult and neonatal cells and after oxidative stress. NAC penetrates the cell membrane easily while GSH hardly permeates. We measured their capacity to enhance intracellular non-protein thiols (NPSH), after inducing damage to the membrane by formation of defects.

Effect of radiation on red cell membrane and intracellular oxidative defense systems.

Ionizing radiation is currently used for prevention of transfusion associated graft versus host disease (TAGVHD). As radiation damage is associated with the production of activated oxygen species, the aim of this study was to observe the immediate effect of ionizing radiation on red cell membrane and intracellular oxidative defense systems. Neonatal and iron deficiency (IDA) cells, known for their increased sensitivity to oxidative stress, were chosen and compared with normal cells.

Prolonged storage of red cells: the effect of pH, adenine and phosphate.

Prolonged storage of red blood cells (RBCs) at 4 degrees C results in decreased intracellular ATP levels with diminished posttransfusion survival. Meryman described a preservative medium, exceptional in its capacity to increase these intracellular levels during the first weeks of storage and later in maintaining adequate levels, for extended storage periods. We modified this medium, investigated its constituents, and found that its ATP-preserving effect was unrelated to its tonicity or to the presence of mannitol.

Iron deficiency anemia: recovery from in vitro oxidative stress.

Red blood cells in iron deficiency anemia (IDA) have a decreased activity of essential antioxidant enzymes. The present study examined the effect of in vitro exposure to oxidative agents in IDA cells and their recovery capacity. Red cells of 26 IDA patients and 10 healthy subjects were examined.

Effect of vitamin K on neonatal erythrocytes.

This study investigated the possible oxidative effect of vitamin K3 (menadione) and Vitamin K1 (Konakion) on neonatal erythrocytes by controlled in vitro exposure. Menadione caused only mild morphological changes and did not decrease ATP levels. However, it oxidized intracellular hemoglobin to methemoglobin in neonatal cells more than in adult cells.

Predisposing factors in bladder calculi. Review of 100 cases.

One hundred patients, aged twenty to ninety-two years, underwent 111 procedures for removal of bladder calculi. Most patients (88) had some type of bladder outlet obstruction. Two types of stones were identified: those that had apparently formed in the upper tract and been trapped in the bladder (17 cases) and those that appeared to have formed in the bladder in the presence of various types of outlet obstruction.

Oxidative stress in newborn erythrocytes.

Phenylhydrazine (PHZ) exposure is used to study in vitro red cell aging mechanisms dependent on Hb oxidation. The effect of PHZ on normal neonatal red blood cells was studied in unseparated blood and after separation into light and heavy cells. PHZ caused more extensive morphologic changes in neonatal than in adult red blood cells.

Prolonged storage of red cells with ammonium chloride and mannitol.

Recently, a new preservation medium consisting of ammonium chloride added to adenine, glucose, mannitol, citrate, and potassium phosphate, was described. Unexpectedly, the predominant effect on red cell storage was an initial elevation of ATP levels, followed by remarkable maintenance of these levels at 12 to 18 weeks with acceptable 24-hour survival. The aim of the study reported here was to investigate the reasons for the advantageous effects of the different constituents.

Storage-induced changes in human newborn red cells.

Fetal red cells are well suited for intrauterine life; however, little is known about their response to postnatal environments. The purpose of this work was to investigate the metabolic and membrane changes affecting newborn red cells during their exposure to storage in citrate-phosphate-dextrose (CPD) and citrate-phosphate-dextrose-adenine (CPDA-1). The findings suggest that newborn red cells are affected more by storage than are adult cells.

Liquid stored erythrocytes: agglomeration, morphology, sialic acid, and toluidine blue uptake studies.

Increased tendency to reversible agglomeration in erythrocytes in outdated units has been previously demonstrated. This phenomenon occurred while post transfusion viability was still acceptable. In the present study erythrocytes of units with early agglomeration were investigated and compared with those with late agglomeration.

Erythrocyte agglomeration and survival studies in citrate-phosphate-dextrose (CPD) units.

We have previously reported increased tendency to agglomeration in CPD-stored erythrocytes. In the present study we investigated the deterioration pattern of fresh units, as detected by agglomeration, free hemoglobin levels, ATP levels, osmotic fragility, and certain enzymatic activities. When the negative test was converted to a positive one, the 24-h survival values of these units were determined by autotransfusion.

Changes in agglomeration of human red blood cells in liquid storage in CPD media.

A procedure which may distinguish between old and new CPD blood units in liquid state is described. It is based on the observation of increased tendency to reversible agglomeration in old erythrocytes in liquid preservation. Erythrocytes clump together when they are mixed with low ionic strength solutions in pH range of 5.